GARY JOHN VICIK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

NOT RENEWED

Business

First Name

GARY JOHN

Last Name

VICIK

Suffix

Business Name

GARY JOHN VICIK MD

Original Issue Date

03/06/1998

Effective Date

03/06/1998

Expiration Date

07/31/2005

City

GLEN CARBON

State

Zip

62034

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020